ARE you suffering from headache ignoring or self medication!can be alarming

Headache is a very common symptom, but it may be alarming sign of some deadly disease which may cutshort your life line, or it may be due to your habit of taking painkillers for headache, in some cases it can lead to blindness, so be cautious and read below which kind of headache you are suffering from...headache is the most common reason that pateint seeks medical attention, there are 2 types of headaches, primary and secondary, which illustrates following causes, Primary headache includes-Tension type headache -70%, Migraine-16%, Idiopathic-2%, Exertional-1% and cluster type 0.1% Secondary headaches : 64%- includes systemic infection, headinjury-4%, vascular disorders-1%, and brain tumors 0.1% (source: After J Oslesen, Philadelphia) Physiology:- Pain occurs when peripheral nociceptors are stimulated, or when producing pathways of CNS or Peripheral nervous system are damaged or activated. Cranial structures producing pain are- scalp, middle meningeal artery, dural sinuses, falx cerebri etc. Clinical Evaluation of New-Onset headache: In new onset and severe headache, there is more possibility of finding a serious cause, if you find any of the symptoms, it means some serious disorder is there. worst headche ever, first severe headache, fever or unexplained systemic signs, vomiting before headache, pain on bending, coughing, lifting, awekening, pain with local tenderness. A patiend with abnormal examination and history of headache must be evaluated with CT and MRI. Secondary headaches 1. Meningitis:- Severe headaches with stiff neck and fever, painful eyemovements. 2. Intracranial Hemorrages:- Acute severe headache with stiff neck but with out fever suggest subarachnoid hemorrage. If hemorrage is small and below foramen magnum, head CT scan can be normal in that case Lumber Puncture should be done. 3. Brain Tumors:- Intermittent, dull aching pain of moderate intensity, may worsen with exertion or change in postion may be associated with nausea and vomiting. 4. Temporal Arteries:- Inframmatory disorder of Extracranial carotid circulation, common in elderly, found in 77 per one lakh person greater than 50 years of age. Half of them when untreated develop blindness due to involvement of ophthalmic artery which is treated with glucocorticoids. Scalp tenderness is present often to a marked degree, brushing the hair or resting head on a pillow is very painful, headache is severe at night and aggravated by exposure to cold. 5. Glaucoma Primary Headache Syndromes: This is the headache in absence of any exogenous cause:- like glare, bright lights, sounds, hunger, stress, physical exertion, stormy whether, barometric pressure changes, lack of sleep, excess sleep, alcohol use. Migraine headache It is a episodic headache associated with certain features such as senstivity to sound, light, movements, nausea, vomiting, are accompanied by the pain. A high index of suspicion is required to diagnose migraine: the migraine aura, consisting of visual disturbances with flash lights, or zig-zag lines moving across the visual field. Migrain is a headache with associated features and if features are absent the it is known as Tension Type Headache. Tension Type Headache:- It is characterised by tight band around the head with no other symptoms as explained in migraine. Approach to the patients in chronic daily headache:- First of all diagnosis is very important, if patient is having daily pain for more than four hours per day it may suggest chronic migraine, chronic tension type headache, hemicrania continua. If its occuring for less than four hours daily it suggests chronic cluster headache, chronic paroxysmal hemicrania, SUNA hypic headache. Preventive treatment is amitriptilline 1 mg/kg body wt. Medication Overuse Headache:- Overuse of medicines can aggravate headache frequency and induce a state of daily headache called medication overuse headache. In order to treat it medication dose should be reduced by 10% every week, even when not treated it requires hospitalization and detoxification. Low CSF volume headache:- It begins when pt. sits or stands up right and improves on reclining, pain is occipito frontal, dull aching pain , may be throbbingm common after lumbar puncure. Treatment---- bed rest, caffiene is given intravenously Raised CSF volume headache:- this pain is present when patient awakens from sleep early in the morning, and pain improves as day passes, its checked by examining Fundus. Hemi Crania Continua: women has double chances of developing it compared to males, mostly present in 10-60 years of age group, treatment is done by indomethacin.